Dadun Collection:http://hdl.handle.net/10171/34592019-09-15T11:54:47Z2019-09-15T11:54:47ZPredictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trialhttp://hdl.handle.net/10171/417552019-04-03T07:34:00Z2016-01-01T00:00:00ZTitle: Predictors of short- and long-term adherence with a Mediterranean-type diet intervention: the PREDIMED randomized trial
Abstract: Abstract
Background: Dietary intervention success requires strong participant adherence, but very few studies have
examined factors related to both short-term and long-term adherence. A better understanding of predictors of
adherence is necessary to improve the design and execution of dietary intervention trials. This study was designed
to identify participant characteristics at baseline and study features that predict short-term and long-term
adherence with interventions promoting the Mediterranean-type diet (MedDiet) in the PREvención con DIeta
MEDiterránea (PREDIMED) randomized trial.
Methods: Analyses included men and women living in Spain aged 55–80 at high risk for cardiovascular disease.
Participants were randomized to the MedDiet supplemented with either complementary extra-virgin olive oil
(EVOO) or tree nuts. The control group and participants with insufficient information on adherence were excluded.
PREDIMED began in 2003 and ended in 2010. Investigators assessed covariates at baseline and dietary information
was updated yearly throughout follow-up. Adherence was measured with a validated 14-point Mediterranean-type
diet adherence score. Logistic regression was used to examine associations between baseline characteristics and
adherence at one and four years of follow-up.
Results: Participants were randomized to the MedDiet supplemented with EVOO (n = 2,543; 1,962 after exclusions)
or tree nuts (n = 2,454; 2,236 after exclusions). A higher number of cardiovascular risk factors, larger waist
circumference, lower physical activity levels, lower total energy intake, poorer baseline adherence to the 14-point
adherence score, and allocation to MedDiet + EVOO each independently predicted poorer adherence. Participants
from PREDIMED recruiting centers with a higher total workload (measured as total number of persons-years of
follow-up) achieved better adherence. No adverse events or side effects were reported.
Conclusions: To maximize dietary adherence in dietary interventions, additional efforts to promote adherence
should be used for participants with lower baseline adherence to the intended diet and poorer health status. The
design of multicenter nutrition trials should prioritize few large centers with more participants in each, rather than
many small centers.
Trial registration: This study was registered at controlled-trials.com (http://www.controlled-trials.
com/ISRCTN35739639). International Standard Randomized Controlled Trial Number (ISRCTN): 35739639. Registration
date: 5 October 2005.
Trial design: parallel randomized trial.2016-01-01T00:00:00ZLa preparación para el amor en la era digital.http://hdl.handle.net/10171/166182019-04-12T09:37:32Z2011-02-19T00:00:00ZTitle: La preparación para el amor en la era digital.2011-02-19T00:00:00Z